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TRICARE Prime Remote Determination of Eligibility Request

By law, you can only use TRICARE Prime Remote if both your (the sponsor's) home and work addresses are more than 50 miles (or one hour's drive time) from a military hospital or clinic. If you don't live and work in a designated remote location, you may submit a Determination of Eligiblity Request if you believe that one or more of the exceptions to the eligibility criteria are met:

  • Your unit is in one region, but you live in another region
  • You and your unit are in one region, but closest primary care manager is in another region
  • Geographic barriers or other unique situations exist (e.g. the drive time to the nearest military hospital or clinic exceeds one hour)

Only the service member or the Unit Commander may request a Determination of Eligibility Request.

* Denotes a required field

* Select a Region

SERVICE MEMBER INFORMATION

* Service Member Name must be filled in
* Select a status
* Select a service branch
*Member rank and pay grade must be filled in
* Home Address must be filled in
* Home phone number must be filled in
* Work phone number must be filled in
* Email must be filled in
* Enter valid email

UNIT INFORMATION

* Unit name must be filled in
* Work address must be filled in
* Unit phone number must be filled in
* Commander name must be filled in
* Commander phone number must be filled in
* Commander Email must be filled in
* Enter valid commander email

REASON(S) YOU ARE REQUESTING THE TPR DETERMINATION *

Select the Scenario That Applies

Required: Select the Scenario That Applies
* Select a scenario
* Submission date must be filled in

Last Updated 10/18/2017